If you have moderate to severe acne, especially when it has started to scar your face, I would recommend oral medication with topical treatment. It is not uncommon that both males and females are not able to swallow pills. There are some suitable antibiotic suspension. Treatment duration is of at least 3 months or more. In order to optimise the outcome, topical treatment with retinoid and benzylperoxide will be prescribed. Compliance is crucial to ensure optimal outcome.
First and foremost, you need to control your acne, using options like topical treatment with or without oral medications such as antibiotics and isotretinoin in order to prevent more dark spots on your face. They are not scars, but merely post-inflammatory hyperpigmentation after an outbreak of acne. Lightening cream, and pigment lasers can be administered. Your dermatologist can advise on the right treatment options for these pigmentations. Sunscreen is also important to prevent further darkening. Choose an oil-free based sunscreen of at least spf 50.
What can I do about it? Adult female acne is common, and acne spots usually appear around the jawline and chin. Quite often, there is no association with hormonal influence. Your dermatologist can help to arrange tests to rule out polycystic ovarian syndrome if there is a complaint of irregular and heavy menses. Recurrence is high after completion of a course of oral antibiotics or topical treatment, hence I would normally recommend oral isotretinoin for a period of at least 6 months. This treatment is not suitable if one is trying to conceive. In such cases please discuss the treatment options with your dermatologist, e.g. suitable “pregnancy-safe” topical treatment +/- oral antibiotics together with hydrafacial and LED light.